Assisted Living: Easier and Better

At the upper end of the new-condo market, the question is “What bubble?” Amenities and conveniences explain why prices haven’t come down much.

The staff at Renaissance Gardens, an assisted-living facility in Springfield, is getting old—fast. On any given day, staff members from cooks up to the director go through training exercises that simulate what it’s like to be an elderly resident: perhaps wearing glasses covered in Vaseline or eating a communal meal with cotton balls in their ears.

“When we first tell the trainees what they’re going to do, their faces say, ‘You’re crazy,’ ” says Ben Cornthwaite, director of extended care. “But within seconds of starting, you can see a transformation. You see a sensitivity that we could never teach with a textbook.”

A well-trained staff is just one of many benefits available at assisted-living facilities around Washington. Expanded menus, specially designed baths, and other “luxuries” contribute to a higher quality of life—for those who can afford them.

Assisted-living facilities and continuing-care retirement communities (CCRCs) have become increasingly expensive as they redefine what assisted living should be. More facilities go beyond providing help with bathing and dressing for those who aren’t ready for a nursing home but need something more than independent living.

“Assisted living can be pricey. As a result, there’s a lot of effort to make the setting an incredibly pleasant one,” says Elinor Ginzler, AARP’s director of livable communities, whose staff works to improve senior housing and moderate its price. “What they’re marketing is that not only can you have your care needs met but you also can live a lovely life.”

Residents in many local assisted-living facilities now enjoy impressive amenities from spalike services to on-site driving ranges. The places highlighted here stand out in several areas.

McLean-based Sunrise Senior Living serves 40,000 mostly assisted-living residents in 35 states. According to communication manager Meghan Lublin, chefs talk often with residents for insight on their preferences, and menu items can be altered to suit them. Some facilities even seek gourmet chefs to oversee the dining room.

Bathing is also taken to a new level at Grand Oaks with “bathtiques.” These dimly lit rooms include hydrotubs similar to what you’d see at a spa, aromatherapy, and soothing music. But the bathtiques are designed with seniors’ needs in mind: Each hydrotub has a sealed door that opens so a person can slide in without having to step over the tub wall and risk falling. The bather sits on a bench as warm water fills the tub and soothing jets begin. “The hard pressure that comes from a showerhead can damage their already fragile skin,” Lublin explains, “and showerheads distribute water unevenly, leaving the resident cold in areas that are not constantly covered by water. The bathtiques solve all of these issues.” Residents can use them instead of or as a supplement to bathing in their own apartments.

Grand Oaks is on the campus of Sibley Memorial Hospital. Sunrise has its own 24-hour nursing department, and residents have access to many of Sibley’s services, including rehabilitative care. Residents can chose between living in their own studio, a one-bedroom, or a two-bedroom apartment. Monthly rates start at $4,800 and go to $9,400. The entry fee is typically two months’ rent.

Bob DeMaria, administrator of Arleigh Burke Pavilion (1739 Kirby Rd., McLean; 703-506-6900; vinsonhall.org)—the assisted-living and nursing section of Vinson Hall—says residents, who can age in place, have high expectations.

Its theater has tiered seating for 25 people, and free movies are shown six days a week. “For a long time they wanted only the old black-and-white films,” DeMaria says, “but as the population has gotten a little younger, they want more current movies.” Residents can also catch events like the Super Bowl and the Academy Awards on the big screen. The on-site salon specializes in hair and beauty services for the elderly.

Social activities help maintain the liveliness of many residents. Happy hour is a favorite activity at many facilities, says Ginzler of AARP, and for good reason: “There’s no reason residents shouldn’t gather at 4 pm and have their glass of wine or their cocktail—especially if they have done so for a lifetime.” Sure enough, DeMaria had so many happy-hour requests at Arleigh Burke that he finally had to designate an official one every month. From 4 to 5 pm, 80 percent of assisted-living residents gather; there is a two-drink maximum, but both are free.

Arleigh Burke costs between $6,000 and $7,000 a month, all of which goes back into operating the nonprofit.

Then there are more-exotic activities. Marian Manor (5345 Marian La., Virginia Beach; 757-456-5018; marian-manor.com) is getting attention for what AARP Bulletin named one of “ten great ideas” in assisted living: winemaking. Every fall, residents take a trip with amateur winemaker Ron Peperak to Blackwater, a nearby vineyard. The 25-member Vintage Vintners can either walk the vineyards or cruise around in golf carts to pick grapes. Peperak brings residents back to Marian Manor to refrigerate the grapes. The next day, members halve and mash them: “Residents ask if they can crush the grapes like Lucy and Ethel, but we can’t put feet in the wine,” says Peperak. “So they crush them with their fingers. We have a good time.” Plus, mashing the cold material is therapeutic for arthritis and rheumatism.

Over the following days, residents sanitize, taste, and add yeast to their product. Peperak checks the fermenting wine, and residents continue weekly tastings. When all are satisfied, the group bottles, corks, names, and labels the wine—which has won awards in the Winemaker International Amateur Wine Competition.

“I try to make sure they see things, smell things, touch things; they involve all of their senses and memories,” Peperak says. “Over here, people don’t just sit.”

There are four levels of care at Marian Manor, ranging from independent living to the equivalent of a nursing home. Rates go from $2,600 to $4,500 a month. The minimum age is 62; the average is 86. The entry fee is equivalent to one month’s rent.

Renaissance Gardens (7470 Spring Village Dr., Springfield; 703-913-1200; www.ericksoncommunities.com/gsv) is an assisted-living facility that’s part of Greenspring, a continuing-care retirement community operated by Erickson Communities.

CCRCs often have big campuses with many more amenities than assisted-living facilities alone. Renaissance Gardens residents have access to everything the independent residents of Greenspring do: five restaurants, an aquatic center, a fitness center, a driving range for golfers, and activities such as shopping trips to New York. The driving range overlooks a lake, and residents take shots at floating pins.

There is also a television studio where residents produce an hourlong community news program at 10 am. The show is mostly live with occasional filmed segments. The host, Dr. Marcia Dake, is in her mid-eighties; other residents help with writing, filming, and producing.

The initial fee for an apartment in independent or assisted living at Greenspring ranges from $100,000 to $500,000. That fee is considered a deposit because it’s refundable and the money eventually goes back into each resident’s estate. Monthly fees are $3,000 to $4,700.

Though much of the hefty fees pay for the luxuries at Renaissance Gardens, Cornthwaite says, the most impressive thing the facility offers is intangible: a staff trained in “person-centered care.”

At Renaissance Gardens, the typical hierarchy of an assisted-living facility is flipped. Certified nursing assistants are typically the lowest paid, but they know the most about how residents live. So CNAs conduct intense sessions to get the rest of the staff to understand what it’s like to be elderly.

All Renaissance Gardens staff are taught to understand the experiences of an older person by wearing glasses covered in Vaseline, with cotton balls in their ears and noses, as they attempt to eat a meal. In another exercise, employees hold a four-hour meeting while wearing a water-soaked adult brief; once staffers go through this discomfort, they say, they can better understand why residents with incontinence problems might isolate themselves.

“It’s the details of whatever sensitivity training we were working on that we’re relating to the bigger picture—how to better deliver healthcare services—and that’s what’s so invigorating to me,” says Cornthwaite. “We want to be able to sympathize and empathize.”